Yesterday, Ohio’s 131st General Assembly passed HB 216, the APRN Modernization Bill. HB 216 will be forwarded to the Governor who is expected to sign before the end of December.
Ninety days after the Governor signs the bill it will become law. OAAPN takes this moment to thank our legislators, healthcare colleagues, community supporters, friends and families in encouraging this three year journey of changing APRN barriers to practice and thereby, improving healthcare access to all Ohioans.
Key aspects of this legislative change
Starting late March 2017 APRNs who apply for authorization to practice in Ohio will receive two licenses if all requirements from the Ohio Board of Nursing are met. The first license will be as a registered nurse. The second license will be as an advanced practice registered nurse with role designated (CRNA, CNM, CNS or CNP)
- An APRN may not practice as an APRN without an active registered nurse license and an active APRN license.
- When APRNs who apply for license renewal in 2017, the applicant must have a total of 48 hours of CE: (1) 24 hours for the registered nurse license which must include one hour Category A CE on Ohio Nursing Practice Law. (2)
- 24 hours for the advanced practice registered nurse license which must include 12 hours of pharmacology. Forty-eight hours of CE every two years will be the baseline continuing education hours needed for APRN license renewal moving forward.
- The new APRN license provides prescriptive authority for CNMs, CNSs and CNPs. The certificate to prescribe and the externship has been eliminated.
- APRNs who currently have a COA and a CTP/CTP-E will be grandfathered into the new APRN license.
- It is not known what the OBON will mandate for APRN’s who currently do not have a CTP.
Starting in late March 2017 the APRN Drug Formulary will be exclusionary only. The formulary will only list those drugs or classifications that an APRN may NOT prescribe. The column, “In accordance with the SCA” will be eliminated. Essentially, if the drug or its classification is NOT listed in the Formulary, the APRN may prescribe.
- All restrictions on furnishing sample medications has been revoked.
- APRNs may not provide controlled substances as a sample.
- The collaborating ratio of 3 APRNs to 1 physician for prescribing has been expanded to 5 APRNs to 1 physician.
Starting in late March 2017 APRNs with DEA numbers ay now prescribe Schedule 2 medications to residents in assisted living facilities. Additionally, the three conditions for prescribing Schedule 2 medications in non-authorized sites has been modified:
- The patient must have a terminal condition.
- The initial Schedule 2 medication must have been prescribed by a physician (no longer needs to be the collaborating physician).
- The Schedule 2 medication may now be written for 72 hours instead of 24 hours.
Starting in late March 2017 the Standard Care Arrangement (SCA) no longer requires a provision for 1) a Procedure for Regular Review of Referrals to Other Health Professionals and Chart Review and 2) a policy for care of infants up to age one and recommendations for collaborating physician visits for children from birth to age three.
- There will now be a 120 day “buffer” period for the SCA when a physician terminates a collaboration with an APRN. Upon notification from the collaborating physician of an end to the collaboration, the APRN will notify the OBON. When the OBON receives the notification the 120 day period will begin. During this buffer period the former SCA remains in effect to allow the APRN to continue to practice while searching for another collaborating physician.
- A copy of the SCA is no longer required to be kept at the place of service where the APRN works. The SCA is to be kept on file by the APRN’s employer.
Starting in late March 2017 a psychiatric certified clinical nurse specialist may have a collaborating physician who has the same or similar specialty or a physician who practices in primary care as a family medicine, internal medicine or pediatric physician.
Starting in late March 2017 the OBON will form an APRN Advisory Committee to advise the board on APRN practice issues.
Starting in late March 2017 APRNs and physician assistants who provide care for school age children with diabetes will be able to write orders that are followed by healthcare providers at the schools.
Though the changes to the Nurse Practice Act for APRNs are significant and brings relief from many barriers that impact our patients, OAAPN is not done. Watch for our new legislative agenda for the next General Assembly in January 2017. Click HERE for a link to the final version of HB 216. If you have any questions, please contact us at firstname.lastname@example.org.